USF College of Behavioral & Community Sciences

USF College of Behavioral & Community Sciences Department of Child and Family Studies Rehabilitation and Mental Health Counseling Scholarship Application

Please check the scholarships for which you are applying. You may apply for one or both.

Susan D. Kelley RMHC Textbook Scholarship (double click on the box to check)

Calvin M. Pinkard Scholarship (double click on the box to check)

Please submit the following information and include all of the items in Sections II - V below.

1. STUDENT INFORMATION

First Name: ______Last Name:______

Student ID (U#):______

Email address: ______

Local Mailing Address: ______

City, State, Zip: ______

How many credit hours have you successfully completed thus far in the RMHC Master’s program (do not include the classes in which you are currently enrolled)? ____

Current GPA in the RMHC Master’s program: ______

Have you ever been on academic probation in the RMHC Master’s program?

Yes, On what date did you return to good standing? ______II. ESSAYS

A. Susan D. Kelley Textbook Scholarship. These awards are based on financial need. Please write a 500 word essay describing the rationale for your request for a need- based scholarship. (Note: these essays will be read by the RMHC Scholarship Committee. They may also be shared with the other RMHC core faculty members, but no one else will see what you have written.)

B. Calvin M. Pinkard Scholarship. Please write a 500 word essay stating how you intend to use the funds, and how you plan to use your degree to benefit others and your community. (Note: these essays will be read by the RMHC Scholarship Committee. They may also be shared with the other RMHC core faculty members, but no one else will see what you have written.)

III. SCHOOL ACTIVITIES, COMMUNITY INVOLVEMENT, LEADERSHIP

Please provide a list of any academic honors, extracurricular activities, leadership activities, community service, research activities, etc.

IV. Please include your CURRICULUM VITA or RESUME with your application.

V. STUDENT CERTIFICATION

Please note that scholarship awards may impact the amount and level of funding you receive from other sources of financial aid administered by the University.

All application materials must be submitted by 5:00 pm on _ 4/15/2017 .

By signing this application, you give permission to the RMHC faculty and staff involved in the scholarship award process to view your student records in order to verify your application.

I certify that the statements contained in this application are true and complete. I understand that fraudulent information will result in disqualification and other academic penalties. I hereby allow my educational information (including GPA and number of hours) to be confirmed in OASIS/Banner. ______Signature Date

Completed Application Packet should be submitted by email to Dr. Rick Weinberg at [email protected] on or before 5pm on 4/15/2017. Please put “RMHC Scholarship Application” in the email Subject line. Once checked for completeness, the application packet will be forwarded to other members of the RMHC Scholarship Committee for review and may be shared with the RMHC core faculty.